The Developmental Disabilities team provides case management services to persons with developmental disabilities and assists individuals in gaining access to needed social, medical, education, and other supports and services. Case management is designed to assist individuals with developmental disabilities and then emerging needs.

Annie Napoli
Disabilities Services & Adult Foster Care

Adult Foster Care means the provision of food, lodging, protection, supervision, and household services to a functionally impaired adult in a residence and may also include the provision of personal care, household and living skills assistance or training, medication assistance and assistance safeguarding cash resources.

Adult Foster Care licenses are issued through the individual counties and are available for settings of five or fewer residents. An adult foster care license holder may have a maximum license capacity of five if all persons in care are age 55 or over and do not have a serious and persistent mental illness or a developmental disability.

There are two types of adult foster care.
- Family Adult Foster Care is an adult foster care home that is the primary residence of the license holder, and in which the license holder is the primary care giver.
- All other adult foster care arrangements are considered Corporate Adult Foster Care.

The Home and Community Based Waiver for Persons with Developmental Disabilities (DD Waiver) provides funding for certain home and community-based services for children and adults with Developmental Disabilities.

This waiver program includes all MA covered services including home care services, if they are necessary to assure health and safety of an individual.

Covered services include:
- Adult Day Care
- Assistive Technology
- Caregiver Training and Education
- Case Management
- Chore Service
- Crisis Respite
- Consumer-Directed Community Supports
- Consumer Training and Education
- Day Training and Habilitation
- Environmental Accessibility Adaptations
- Homemaker
- Housing Access Coordination
- In-Home Family Support
- Live-in Personal Caregiver Expenses
- Personal Care Assistant Services (PCA) (Extended 1:1; Extended 1:2; Extended 1:3)
- Personal Support
- Respite Care (In-home; Out-of-home)
- Specialist Service
- Supported Employment
- Supported Living Services (Adult; Child)
- Transportation
- Adult Day Care Bath
- Home Delivered Meals
- Transitional Services
- 24-Hour Emergency Assistance

Developmental Disabilities (DD) Waiver provides funding for certain home and community-based services for children and adults with DD.

Eligibility for the MR/RC Waiver is determined by a screening by the county called a DD Screening. To be eligible for the MR/RC Waiver, a person must meet all these criteria: be a Medical Assistance recipient or be eligible for MA; be determined to have mental retardation or a related condition; be determined to likely require the level of care provided to individuals in an intermediate care facility for persons with mental retardation or related conditions (ICF/MR); and make an informed choice requesting home and community-based services instead of ICF/MR services.

There are no fees attached to waiver enrollment, however families of children may be required to pay a parental fee for services depending on family income.

The Community Alternatives for Disabled Individuals (CADI) Waiver provides funding for home and community-based services for children and adults, who would otherwise require the level of care provided in a nursing facility.

CADI waiver services may be provided to a person:
- living in his/her own home
- in his/her biological or adoptive family's home
- in a relative's home (e.g. sibling, aunt, grandparent etc.)
- a family foster care home or corporate foster care home
- a board and lodging facility or in an assisted living facility

If married, a person may receive CADI services while living at home with his or her spouse.

Covered services include:
- All Medical Assistance covered services
- Adult Day Care
- Adult Day Care Bath
- Assisted Living
- Assisted Living Plus
- Case Management (PHN/Social Worker)
- Case Management Aide (Paraprofessional)
- Family Counseling and Training
- Foster Care
- Home Delivered Meals
- Home Health Aide, Extended
- Homemaker
- Independent Living Skills
- LPN (Regular Home Health, Extended; Shared Home Health, Extended 1:2)
- LPN (Complex Home Health, Extended)
- Modifications to home or vehicle
- Occupational Therapy or Assistant Extended Home Health
- Personal Care Assistant (Extended 1:1, Extended 1:2; Extended 1:3)
- Physical Therapy or Assistant, Extended Home Health
- Prevocational Services
- RN (Regular Home Health, Extended
- Shared Home Health, Extended 1:2)
- RN (Complex Home Health, Extended)
- Residential Care Services
- Respiratory Therapy, Extended Home Health
- Respite Care (In-home; Out-of-home)
- Speech Therapy, Extended Home Health
- Supplies and Equipment
- Supported Employment services
- Transportation (One Way Trip)
- Transportation-Mileage
- Transportation-Mileage (Noncommercial Vehicle)
- Consumer Directed Community Supports
- Transportation-Attendant and Transitional services.

Eligibility for the CADI Waiver is determined from a county Long-Term Care Consultation (LTCC). To be eligible for the CADI Waiver, the following must be true: 1) Be eligible for Medical Assistance (MA). Eligibility for MA is based only on your income and assets, even though you may live with your parents or spouse. 2)Be under the age of 65 years at the time of application. 3) Be determined to likely require the level of care provided to individuals in a nursing facility. 4) Choose care and services in the community instead of a nursing facility. 5) Be certified disabled by the State Medical Review Team or by the Social Security Administration. 6) Require a service not available from other funding sources (Medical Assistance, Medicare, Private Insurance); Recipients who have mental illness may be eligible for CADI if they meet the CADI eligibility criteria. This applies when mental illness is the only diagnosis or when the recipient has another type of disability and a mental illness.

There are no fees attached to waiver enrollment, however families of children may be required to pay a parental fee for services depending on family income.

The Traumatic Brain Injury Waiver (TBIW) provides funding for home and community-based services (HCBS) for children and adults who have acquired a traumatic brain injury.

TBI Waiver services may be provided to a person living in his/her family's home, in a relative's home, in a family foster care home, in a corporate foster care home, in a board and lodging facility or in an assisted living facility. If married, a person may receive TBI Waiver services while living at home with his or her spouse.

There are two levels of care under the TBIW:
1) Nursing facility (NF) level is for persons who: have significant cognitive and behavioral impairments and require the level of care found in nursing facilities that provide specialized services for persons with brain injury.
2) Neurobehavioral (NB) hospital level is for persons who: have significant cognitive impairment; have severe behavioral impairment in one of the following areas:
- damage to property
- inappropriate sexual activity
- injury to others
- injury to self
- physical aggression
- require a 24-hour plan of care including a formal behavior support plan
- require that intensive behavioral intervention be available
- need service and support that exceed what can be provided by the TBIW-NF level
- require the level of care and behavioral support provided in a neurobehavioral hospital

Covered services include:
- All MA covered services
- Adult Day Care
- Adult Day Care Bath
- Assisted Living
- Assisted Living Plus
- Behavioral Programming (by Professional; Analyst; Specialist; Aide)
- Case Management
- Case Management Aide (Paraprofessional)
- Chore Services
- Cognitive Therapy (by Professional, Extended; by BA/BS Personnel, Extended)
- Companion Services
- Family Counseling and Training
- Foster Care
- Home Delivered Meals
- Home Health Aide, Extended
- Homemaker Services
- Independent Living Skills (Counseling; Maintenance)
- Independent Living Skills Therapies (ILS: Individual; Group)
- LPN (Regular Home Health, Extended; Shared Home Health, Extended 1:2)
- LPN (Complex Home Health, Extended)
- Mental Health Testing
- Mental Health Psychological Testing, Extended
- Modifications
- Night Supervision
- Occupational Therapy or Assistant, Extended Home Health
- Personal Care Assistant (Extended 1:1; Extended 1:2; Extended 1:3)
- Physical Therapy or Assistant, Extended Home Health
- Prevocational Services
- RN (Regular Home Health, Extended
- Shared Home Health, Extended 1:2)
- RN (Complex Home Health, Extended)
- Residential Care
- Respiratory Therapy, Extended Home Health
- Respite Care Worker (In-home)
- Respite Care (Out-of-home)
- Speech Therapy, Extended Home Health
- Supported Employment
- Structured Day Program
- Supplies and Equipment
- Transportation (One Way Trip)
- Transitional Services
- Consumer Directed Community Supports
- Transportation-Mileage
- Transportation-Mileage (Noncommercial Vehicle)
- Transportation-Attendant

Eligibility for the TBIW is determined through a screening process. To be eligible for the TBIW a person must meet all these criteria: Be a Medical Assistance recipient or be eligible for MA; Have a diagnosis of traumatic or acquired brain injury or an acquired or degenerative disease diagnosis where cognitive impairment is present; Experience significant/severe behavioral and cognitive problems related to the injury; Be under the age of 65 years at the time of application; Be certified as disabled by the State Medical Review Team or by the Social Security Administration; Be determined to need the level of care available in a nursing facility (NF) or neurobehavioral (NB) hospital; Choose services in the community instead of services in a nursing facility or neurobehavioral hospital; and be assessed at Level IV or above on the Rancho Los Amigos Levels of Cognitive Functioning Scale.

There are no fees attached to waiver enrollment, however families of children may be required to pay a parental fee for services depending of family income.

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Carlton County Sexual & Domestic Abuse Program
Available 24-hours a day. Provides information on support groups and help for victims of domestic and sexual abuse.
1-218-384-8927
1-800-910-1810

Carlton County Public Health & Human Services is about strengthening families, protecting our children and our seniors, offering hope to those in crisis and making our community a stronger, safer & healthier place for all of us to live.